Topic list Flashcards
Chronic bronchitis patients are often called ___ due to ______
Blue bloaters
/mucus plugs –> Hypoxia and hypercapnia
Emphysema patients are often called ___ due to ______
Pink puffers
CO2 retention but no change in O2
Why will we hear crackles at the beginning of inspiration in patient with chronic bronchitis?
Due to opening of small collapsed airways
Hypoxia will cause vaso__
constriction
Hypoxic vasoconc. in lungs will lead to
Increase pulmonary vascular resistance and pulmonary HTN
Types of emphysema
Centriacinar- Smoking
Panacinar- a1-AT deficiency
Paraseptal
Chronic bronchitis definition
Productive cough on most days of the week for at least 3 months with total duration of 2 years
mMRC measures
Breathless scale 0-4
3 steps of combined COPD asessment
Spirometry to confirm diagnosis
Assessment of airflow limitation
Assessment of symp./risk of exacerbations
COPD non-pharmacological treatment
Smokin cessation Smoke prevention Regular exercise Rehabilitation Oxygen therapy NIV (CPAP) Lung Volume Reduction Therapy LuTx
Oxygent therapy- How long per day and what is the indication?
minimum 15h/d
PaO2 < 60 mmHg and <88% O2 saturation
COPD pharmacological treatment other than LABA LAMA ICS..
Influenza vaccine
Mucolytics
AB
Define COPD exacerbation
Acute worsening of respiratory symp. that result in need of additional therapy
How to assess the severity of an exacerbation?
Arterial blood gass
CXR (for alternative diagnosis)
ECG
WBC count
Systemic corticosteroids- What will we give, how much and for how long?
Prednisone
40 mg
5 days
Asthma severity classification
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
Special feature of PEF?
Daily variability > 20%
Anti IgE drug
Omalizumab
Clinical features of asthma exacerbation
Too breathless
Respiratory rate > 25/min
HR > 110 BPM
PEF < 50% of predicted normal or best
PEF value in life threatening situations
< 33%